Pub Date : 2024-07-23DOI: 10.1136/sextrans-2024-056130
Charlotte van der Veer, Chifundo Kondoni, Annie Kuyere, Fatima Mtonga, Vita Nyasulu, George Shaba, Chelsea Morroni, Gladys Gadama, Luis Gadama, Kondwani Kawaza, Queen Dube, Neil French, David Lissauer, Bridget Freyne
Background: There are limited data on the epidemiology of sexually transmitted infections (STI) and their contribution to adverse birth outcomes (ABO) in sub-Saharan Africa (SSA). We performed a case-control study to assess the prevalence of STI and their association with ABO among women attending Queen Elizabeth Central Hospital, Blantyre, Malawi.
Methods: A composite case definition for ABO included stillborn, preterm and low birthweight infants and infants admitted to neonatal intensive care unit within 24 hours of birth. Following recruitment of an infant with an ABO, the next born healthy infant was recruited as a control. Multiplex PCR for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT) and Trichomonas vaginalis (TV) was performed on maternal vaginal swabs. HIV and syphilis status was determined on maternal and infant serum. For syphilis, we used combined treponemal/non-treponemal rapid point-of-care tests in parallel with rapid plasma reagin tests, PCR for Treponema pallidum and clinical parameters to diagnose and stage the infection. We compared STI positivity between cases and controls.
Results: We included 259 cases and 251 controls. Maternal prevalence of STI was 3.1%, 2.7% and 17.1% for NG, CT and TV, respectively. Maternal prevalence of untreated syphilis was 2.0% and 6.1% for early stage and late/unknown stage, respectively; prevalence of treated syphilis was 2.7%. The HIV prevalence was 16.5%. HIV infection significantly increased the odds for ABO (OR=3.31; 95% CI 1.10 to 9.91) as did NG positivity (OR=4.30; 95% CI 1.16 to 15.99). We observed higher rates of ABO among women with untreated maternal syphilis (early: OR=7.13; 95% CI 0.87 to 58.39, late/unknown stage: OR=1.43; 95% CI 0.65 to 3.15). Maternal TV and CT infections were not associated with ABO.
Conclusion: STI prevalence among pregnant women in Malawi is comparable to other SSA countries. HIV, NG and untreated syphilis prevalence was higher among women with ABO compared with women with healthy infants.
背景:在撒哈拉以南非洲地区(SSA),有关性传播感染(STI)的流行病学及其对不良生育后果(ABO)的影响的数据十分有限。我们进行了一项病例对照研究,以评估马拉维布兰太尔伊丽莎白女王中心医院就诊妇女的性传播感染流行率及其与 ABO 的关系:ABO病例的综合定义包括死胎、早产儿、低出生体重儿以及出生后24小时内入住新生儿重症监护室的婴儿。在招募到一名 ABO 婴儿后,再招募下一名出生时健康的婴儿作为对照。对母体阴道拭子进行淋病奈瑟菌(NG)、沙眼衣原体(CT)和阴道毛滴虫(TV)多重 PCR 检测。对母婴血清进行艾滋病毒和梅毒检测。对于梅毒,我们在使用快速血浆试剂检测、苍白螺旋体聚合酶链反应(PCR)和临床参数的同时,还使用了三联/非三联快速床旁检测法来诊断和分期梅毒感染。我们对病例和对照组之间的性传播感染阳性率进行了比较:我们纳入了 259 例病例和 251 例对照。在 NG、CT 和 TV 中,孕产妇的性传播感染率分别为 3.1%、2.7% 和 17.1%。孕产妇未经治疗的梅毒患病率(早期和晚期/未知期)分别为 2.0% 和 6.1%;经治疗的梅毒患病率为 2.7%。艾滋病毒感染率为 16.5%。艾滋病病毒感染与 NG 阳性(OR=4.30;95% CI 1.16 至 15.99)一样,都会明显增加 ABO 感染的几率(OR=3.31;95% CI 1.10 至 9.91)。我们观察到,孕产妇梅毒未经治疗的妇女中 ABO 阳性率较高(早期:OR=7.13;95% CI=1.16-15.99):早期:OR=7.13;95% CI 0.87 至 58.39,晚期/阶段不明:OR=1.43;95% CI 0.65 至 3.15)。孕妇的 TV 和 CT 感染与 ABO 无关:马拉维孕妇的性传播感染率与其他撒南非洲国家相当。与有健康婴儿的妇女相比,有ABO血型的妇女中艾滋病毒、NG和未经治疗的梅毒感染率较高。
{"title":"Prevalence of sexually transmitted infection in pregnancy and their association with adverse birth outcomes: a case-control study at Queen Elizabeth Central Hospital, Blantyre, Malawi.","authors":"Charlotte van der Veer, Chifundo Kondoni, Annie Kuyere, Fatima Mtonga, Vita Nyasulu, George Shaba, Chelsea Morroni, Gladys Gadama, Luis Gadama, Kondwani Kawaza, Queen Dube, Neil French, David Lissauer, Bridget Freyne","doi":"10.1136/sextrans-2024-056130","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056130","url":null,"abstract":"<p><strong>Background: </strong>There are limited data on the epidemiology of sexually transmitted infections (STI) and their contribution to adverse birth outcomes (ABO) in sub-Saharan Africa (SSA). We performed a case-control study to assess the prevalence of STI and their association with ABO among women attending Queen Elizabeth Central Hospital, Blantyre, Malawi.</p><p><strong>Methods: </strong>A composite case definition for ABO included stillborn, preterm and low birthweight infants and infants admitted to neonatal intensive care unit within 24 hours of birth. Following recruitment of an infant with an ABO, the next born healthy infant was recruited as a control. Multiplex PCR for <i>Neisseria gonorrhoeae</i> (NG), <i>Chlamydia trachomatis</i> (CT) and <i>Trichomonas vaginalis</i> (TV) was performed on maternal vaginal swabs. HIV and syphilis status was determined on maternal and infant serum. For syphilis, we used combined treponemal/non-treponemal rapid point-of-care tests in parallel with rapid plasma reagin tests, PCR for <i>Treponema pallidum</i> and clinical parameters to diagnose and stage the infection. We compared STI positivity between cases and controls.</p><p><strong>Results: </strong>We included 259 cases and 251 controls. Maternal prevalence of STI was 3.1%, 2.7% and 17.1% for NG, CT and TV, respectively. Maternal prevalence of untreated syphilis was 2.0% and 6.1% for early stage and late/unknown stage, respectively; prevalence of treated syphilis was 2.7%. The HIV prevalence was 16.5%. HIV infection significantly increased the odds for ABO (OR=3.31; 95% CI 1.10 to 9.91) as did NG positivity (OR=4.30; 95% CI 1.16 to 15.99). We observed higher rates of ABO among women with untreated maternal syphilis (early: OR=7.13; 95% CI 0.87 to 58.39, late/unknown stage: OR=1.43; 95% CI 0.65 to 3.15). Maternal TV and CT infections were not associated with ABO.</p><p><strong>Conclusion: </strong>STI prevalence among pregnant women in Malawi is comparable to other SSA countries. HIV, NG and untreated syphilis prevalence was higher among women with ABO compared with women with healthy infants.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-22DOI: 10.1136/sextrans-2024-056137
Joshua Kostera, Almedina Tursunovic, Paige Botts, Regina Galloway, April Davis, Tong Yang
{"title":"Prevalence of co-infection between high-risk human papillomavirus and common sexually transmitted infections in cervical specimens.","authors":"Joshua Kostera, Almedina Tursunovic, Paige Botts, Regina Galloway, April Davis, Tong Yang","doi":"10.1136/sextrans-2024-056137","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056137","url":null,"abstract":"","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141749002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.1136/sextrans-2024-056143
Raúl Corbalán-Vélez, Jose Antonio Ruiz-Maciá, Diego López-Martínez, Antonio Moreno Docón, Juan Fernández-Pérez, Teresa Martínez-Menchón, Marta Segado-Sánchez, Jose Juan Parra-García, Francisco José Martínez-Ortega, Julia Román-Gómez
Background: Condyloma acuminatum is caused by human papillomavirus (HPV), which typically presents as excrescent, pedunculated, papillomatous lesions which may be of a pale colour. On rare occasions, we have observed pigmented genital lesions that are similar to seborrhoeic keratoses, but with histological findings of condyloma acuminatum and positive genotyping for HPV. We have termed these 'seborrhoeic keratosis-like' type condylomas.
Methods: This is an observational retrospective study. The following clinical data were collected: age, sex, time of evolution, location, isolated or multiple lesions, monomorphous or polymorphous/mixed lesions. HPV genotyping was performed in all cases, and excision for histological study in eight cases.
Results: A total of 31 patients were diagnosed with this type of pigmented condylomata acuminata. Of these, 16 had isolated lesions (less than five lesions) and 15 had multiple lesions. 67% of the lesions exhibited slow growth, with an evolution period of greater than 1 year. The most frequent location was the base of the penis and pubis. HPV genotyping of the lesions was positive in all cases, with the HPV-6 genotype predominating (28 cases, 90.3%). The lesions exhibited dermoscopic differences from other pigmented lesions and histological findings attributable to HPV infection (pseudoparakeratosis, koilocytosis, etc) and others similar to those observed in seborrhoeic keratoses.
Conclusions: A total of 31 patients were diagnosed with pigmented verrucous lesions, excrescents, isolated or multiple, in the genital region. These lesions exhibited clinical characteristics similar to seborrhoeic keratoses, with positive genotyping for HPV. In the majority of cases, the genotype was HPV-6. These lesions have been named 'pigmented condylomata acuminata seborrhoeic keratosis-like'. Only 10 cases of these lesions have been described in the literature.
{"title":"Pigmented acuminated condylomas seborrhoeic keratosis-like: a new entity?","authors":"Raúl Corbalán-Vélez, Jose Antonio Ruiz-Maciá, Diego López-Martínez, Antonio Moreno Docón, Juan Fernández-Pérez, Teresa Martínez-Menchón, Marta Segado-Sánchez, Jose Juan Parra-García, Francisco José Martínez-Ortega, Julia Román-Gómez","doi":"10.1136/sextrans-2024-056143","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056143","url":null,"abstract":"<p><strong>Background: </strong>Condyloma acuminatum is caused by human papillomavirus (HPV), which typically presents as excrescent, pedunculated, papillomatous lesions which may be of a pale colour. On rare occasions, we have observed pigmented genital lesions that are similar to seborrhoeic keratoses, but with histological findings of condyloma acuminatum and positive genotyping for HPV. We have termed these 'seborrhoeic keratosis-like' type condylomas.</p><p><strong>Methods: </strong>This is an observational retrospective study. The following clinical data were collected: age, sex, time of evolution, location, isolated or multiple lesions, monomorphous or polymorphous/mixed lesions. HPV genotyping was performed in all cases, and excision for histological study in eight cases.</p><p><strong>Results: </strong>A total of 31 patients were diagnosed with this type of pigmented condylomata acuminata. Of these, 16 had isolated lesions (less than five lesions) and 15 had multiple lesions. 67% of the lesions exhibited slow growth, with an evolution period of greater than 1 year. The most frequent location was the base of the penis and pubis. HPV genotyping of the lesions was positive in all cases, with the HPV-6 genotype predominating (28 cases, 90.3%). The lesions exhibited dermoscopic differences from other pigmented lesions and histological findings attributable to HPV infection (pseudoparakeratosis, koilocytosis, etc) and others similar to those observed in seborrhoeic keratoses.</p><p><strong>Conclusions: </strong>A total of 31 patients were diagnosed with pigmented verrucous lesions, excrescents, isolated or multiple, in the genital region. These lesions exhibited clinical characteristics similar to seborrhoeic keratoses, with positive genotyping for HPV. In the majority of cases, the genotype was HPV-6. These lesions have been named 'pigmented condylomata acuminata seborrhoeic keratosis-like'. Only 10 cases of these lesions have been described in the literature.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.1136/sextrans-2023-056096
Ronald Moses Galiwango, Godfrey Kigozi, Xinyi Feng, Steven Reynolds, Thomas Quinn, Stephen Dalton Kiboneka, Josephine Mpagazi, John Baptist Kereba, Annet Nakayijja, Robert Ssekubugu, Larry Chang, Joseph Kagayi, Aaron Tobian, Mary K Grabowski
Objective: Voluntary medical male circumcision (MC) is a critical tool in combination HIV prevention programmes in Africa. Self-reported MC (SrMC) status is used in HIV epidemiological surveys to assess MC coverage but is subject to response bias with limited validation. This study evaluated the utility of SrMC status as a marker of MC as well as self-reported genital lesions for genital ulcer disease (GUD) among Ugandan men.
Methods: Male participants aged 18-49 years in the cross-sectional Sexually Transmitted Infection Prevalence study, conducted between May and October 2019, responded to a questionnaire capturing SrMC status and current genital ulcer symptoms followed by clinical assessment to verify MC and presence of GUD.Sensitivity, specificity, positive predictive value, negative predictive value and corresponding CIs (95% CI) for SrMC status and GUD were estimated.
Results: There were 853 male participants, of whom 470 (55.1%) self-reported being circumcised and 23 (2.7%) self-reported GUD (SrGUD). MC was clinically confirmed in 50.2% (n=428) of participants with sensitivity of SrMC status at 99% (95% CI: 98% to 100%) and specificity 89% (95% CI: 86% to 92%). Specificity of SrMC was lowest among persons living with HIV and viremic (>1000 copies/mL) at 72% (95% CI: 46% to 90%). 18 participants had clinically confirmed GUD, but only 12 SrGUD symptoms, corresponding to a sensitivity and specificity of 67% (95% CI: 41% to 87%) and 99% (95% CI: 98% to 99%), respectively.
Conclusions: SrMC status is a robust proxy for clinically confirmed MC status and may reliably be used to assess MC coverage in this setting. Conversely, GUD symptoms were under-reported, which may impact effective syndromic management of sexually transmitted infections and warrants further examination.
{"title":"Validation of self-reported male circumcision status and genital ulcer disease among Ugandan men.","authors":"Ronald Moses Galiwango, Godfrey Kigozi, Xinyi Feng, Steven Reynolds, Thomas Quinn, Stephen Dalton Kiboneka, Josephine Mpagazi, John Baptist Kereba, Annet Nakayijja, Robert Ssekubugu, Larry Chang, Joseph Kagayi, Aaron Tobian, Mary K Grabowski","doi":"10.1136/sextrans-2023-056096","DOIUrl":"https://doi.org/10.1136/sextrans-2023-056096","url":null,"abstract":"<p><strong>Objective: </strong>Voluntary medical male circumcision (MC) is a critical tool in combination HIV prevention programmes in Africa. Self-reported MC (SrMC) status is used in HIV epidemiological surveys to assess MC coverage but is subject to response bias with limited validation. This study evaluated the utility of SrMC status as a marker of MC as well as self-reported genital lesions for genital ulcer disease (GUD) among Ugandan men.</p><p><strong>Methods: </strong>Male participants aged 18-49 years in the cross-sectional Sexually Transmitted Infection Prevalence study, conducted between May and October 2019, responded to a questionnaire capturing SrMC status and current genital ulcer symptoms followed by clinical assessment to verify MC and presence of GUD.Sensitivity, specificity, positive predictive value, negative predictive value and corresponding CIs (95% CI) for SrMC status and GUD were estimated.</p><p><strong>Results: </strong>There were 853 male participants, of whom 470 (55.1%) self-reported being circumcised and 23 (2.7%) self-reported GUD (SrGUD). MC was clinically confirmed in 50.2% (n=428) of participants with sensitivity of SrMC status at 99% (95% CI: 98% to 100%) and specificity 89% (95% CI: 86% to 92%). Specificity of SrMC was lowest among persons living with HIV and viremic (>1000 copies/mL) at 72% (95% CI: 46% to 90%). 18 participants had clinically confirmed GUD, but only 12 SrGUD symptoms, corresponding to a sensitivity and specificity of 67% (95% CI: 41% to 87%) and 99% (95% CI: 98% to 99%), respectively.</p><p><strong>Conclusions: </strong>SrMC status is a robust proxy for clinically confirmed MC status and may reliably be used to assess MC coverage in this setting. Conversely, GUD symptoms were under-reported, which may impact effective syndromic management of sexually transmitted infections and warrants further examination.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.1136/sextrans-2024-056124
Javier Gómez-Castellá, Marta Cobos Briz, Néstor Nuño, Asuncion Diaz, Francisco Javier Bru-Gorraiz, Alejandro Martín-Gorgojo, Maria Concepción Almonacid-Garrido, Anna Mir, Mario Muñoz, Julia Del Amo
Objectives: Sexually transmitted infections (STIs) have markedly increased over the last decade in Spain, calling for prevention and control innovative approaches. While there is evidence indicating the effectiveness of self-sampling for STI diagnosis, no kits for this purpose have been authorised in Spain.
Methods: A prospective single-blind cross-sectional study carried out between November and December 2022 in an STI clinic in Madrid, Spain, to determine the validity, feasibility and acceptability of self-sampling kits used by non-healthcare professionals from vagina, pharynx, rectum and urethra to diagnose Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). Self-samples were compared with samples collected by healthcare professional (HC samples) and analysed by PCR. Frequency of CT and NG diagnosis by sample type was compared using McNemar's test for paired data. Sensitivity and specificity of self-samples for CT and NG diagnosis were also calculated.
Results: 306 self-samples from 51 participants were analysed. 80% were men with median age of 33 (IQR: 28-38) years. Self-samples and HC samples showed no significant statistical differences in CT and NG diagnosis. Self-samples had a sensitivity of 81% for CT and 93% for NG, with a specificity of 97% for CT and 95% for NG. More than 90% of participants had no difficulty understanding the kit instructions and 71% expressed high levels of satisfaction with the self-sampling kit.
Conclusion: Self-sampling kits for CT and NG diagnosis can be safely and effectively used by non-healthcare professionals in Spain. National strategies for STI prevention and control should prioritise self-sampling strategies.
目的:过去十年间,西班牙的性传播感染(STI)明显增加,因此需要采取创新的预防和控制方法。虽然有证据表明自我采样在性传播感染诊断中的有效性,但西班牙尚未批准用于此目的的试剂盒:2022 年 11 月至 12 月期间,在西班牙马德里的一家性传播感染诊所开展了一项前瞻性单盲横断面研究,以确定非医疗保健专业人员使用自我采样试剂盒从阴道、咽部、直肠和尿道诊断沙眼衣原体(CT)和淋病奈瑟菌(NG)的有效性、可行性和可接受性。将自取样本与医护人员采集的样本(HC 样本)进行比较,并通过 PCR 进行分析。采用 McNemar's 检验对配对数据进行分析,比较不同样本类型的 CT 和 NG 诊断频率。此外,还计算了自我样本对 CT 和 NG 诊断的敏感性和特异性:分析了来自 51 名参与者的 306 份自我样本。80%为男性,中位年龄为 33 岁(IQR:28-38)。自我样本和 HC 样本在 CT 和 NG 诊断方面没有明显的统计学差异。自取样本对 CT 和 NG 的灵敏度分别为 81% 和 93%,对 CT 和 NG 的特异性分别为 97% 和 95%。90%以上的参与者在理解工具包说明方面没有困难,71%的参与者对自我采样工具包表示高度满意:结论:在西班牙,非医疗保健专业人员可以安全有效地使用自我采样工具包进行 CT 和 NG 诊断。预防和控制性传播感染的国家战略应优先考虑自我采样策略。
{"title":"Quality, acceptability and usability of self-sampling kits used by non-healthcare professionals for STI diagnosis in Spain: a single-blind study.","authors":"Javier Gómez-Castellá, Marta Cobos Briz, Néstor Nuño, Asuncion Diaz, Francisco Javier Bru-Gorraiz, Alejandro Martín-Gorgojo, Maria Concepción Almonacid-Garrido, Anna Mir, Mario Muñoz, Julia Del Amo","doi":"10.1136/sextrans-2024-056124","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056124","url":null,"abstract":"<p><strong>Objectives: </strong>Sexually transmitted infections (STIs) have markedly increased over the last decade in Spain, calling for prevention and control innovative approaches. While there is evidence indicating the effectiveness of self-sampling for STI diagnosis, no kits for this purpose have been authorised in Spain.</p><p><strong>Methods: </strong>A prospective single-blind cross-sectional study carried out between November and December 2022 in an STI clinic in Madrid, Spain, to determine the validity, feasibility and acceptability of self-sampling kits used by non-healthcare professionals from vagina, pharynx, rectum and urethra to diagnose <i>Chlamydia trachomatis</i> (CT) and <i>Neisseria gonorrhoeae</i> (NG). Self-samples were compared with samples collected by healthcare professional (HC samples) and analysed by PCR. Frequency of CT and NG diagnosis by sample type was compared using McNemar's test for paired data. Sensitivity and specificity of self-samples for CT and NG diagnosis were also calculated.</p><p><strong>Results: </strong>306 self-samples from 51 participants were analysed. 80% were men with median age of 33 (IQR: 28-38) years. Self-samples and HC samples showed no significant statistical differences in CT and NG diagnosis. Self-samples had a sensitivity of 81% for CT and 93% for NG, with a specificity of 97% for CT and 95% for NG. More than 90% of participants had no difficulty understanding the kit instructions and 71% expressed high levels of satisfaction with the self-sampling kit.</p><p><strong>Conclusion: </strong>Self-sampling kits for CT and NG diagnosis can be safely and effectively used by non-healthcare professionals in Spain. National strategies for STI prevention and control should prioritise self-sampling strategies.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-04DOI: 10.1136/sextrans-2024-056105
Souradet Y Shaw, Jeffery C S Biegun, Stella Leung, Shajy Isac, Helgar K Musyoki, Mary Mugambi, Japheth Kioko, Janet Musimbi, Kennedy Olango, Samuel Kuria, Martin K Ongaro, Jeffrey Walimbwa, Faran Emmanuel, James Blanchard, Michael Pickles, Sharmistha Mishra, Marissa L Becker, Lisa Lazarus, Robert Lorway, Parinita Bhattacharjee
Background: While the COVID-19 pandemic disrupted HIV preventative services in sub-Saharan Africa, little is known about the specific impacts the pandemic has had on men who have sex with men (MSM) in Kenya.
Methods: Data were from an HIV self-testing intervention implemented in Kisumu, Mombasa and Kiambu counties in Kenya. Baseline data collection took place from May to July 2019, and endline in August-October 2020, coinciding with the lifting of some COVID-19 mitigation measures. Using endline data, this study characterised the impact the pandemic had on participants' risk behaviours, experience of violence and behaviours related to HIV. Logistic regression was used to understand factors related to changes in risk behaviours and experiences of violence; adjusted AORs (AORs) and 95% CIs are reported.
Results: Median age was 24 years (IQR: 21-27). Most respondents (93.9%) reported no change or a decrease in the number of sexual partners (median number of male sexual partners: 2, IQR: 2-4). Some participants reported an increase in alcohol (10%) and drug (16%) consumption, while 40% and 28% reported decreases in alcohol and drug consumption, respectively. Approximately 3% and 10% reported an increase in violence from intimate partners and police/authorities, respectively. Compared with those with primary education, those with post-secondary education were 60% less likely to report an increase in the number of male sexual partners per week (AOR: 0.4, 95% CI: 0.2 to 0.9), while those who were HIV positive were at twofold the odds of reporting an increase or sustained levels of violence from intimate partners (AOR: 2.0, 95% CI: 1.1 to 4.0).
Conclusion: The results of this study demonstrate heterogeneity in participants' access to preventative HIV and clinical care services in Kenya after the onset of the COVID-19 epidemic. These results indicate the importance of responding to specific needs of MSM and adapting programmes during times of crisis.
{"title":"Describing the effect of COVID-19 on sexual and healthcare-seeking behaviours of men who have sex with men in three counties in Kenya: a cross-sectional study.","authors":"Souradet Y Shaw, Jeffery C S Biegun, Stella Leung, Shajy Isac, Helgar K Musyoki, Mary Mugambi, Japheth Kioko, Janet Musimbi, Kennedy Olango, Samuel Kuria, Martin K Ongaro, Jeffrey Walimbwa, Faran Emmanuel, James Blanchard, Michael Pickles, Sharmistha Mishra, Marissa L Becker, Lisa Lazarus, Robert Lorway, Parinita Bhattacharjee","doi":"10.1136/sextrans-2024-056105","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056105","url":null,"abstract":"<p><strong>Background: </strong>While the COVID-19 pandemic disrupted HIV preventative services in sub-Saharan Africa, little is known about the specific impacts the pandemic has had on men who have sex with men (MSM) in Kenya.</p><p><strong>Methods: </strong>Data were from an HIV self-testing intervention implemented in Kisumu, Mombasa and Kiambu counties in Kenya. Baseline data collection took place from May to July 2019, and endline in August-October 2020, coinciding with the lifting of some COVID-19 mitigation measures. Using endline data, this study characterised the impact the pandemic had on participants' risk behaviours, experience of violence and behaviours related to HIV. Logistic regression was used to understand factors related to changes in risk behaviours and experiences of violence; adjusted AORs (AORs) and 95% CIs are reported.</p><p><strong>Results: </strong>Median age was 24 years (IQR: 21-27). Most respondents (93.9%) reported no change or a decrease in the number of sexual partners (median number of male sexual partners: 2, IQR: 2-4). Some participants reported an increase in alcohol (10%) and drug (16%) consumption, while 40% and 28% reported decreases in alcohol and drug consumption, respectively. Approximately 3% and 10% reported an increase in violence from intimate partners and police/authorities, respectively. Compared with those with primary education, those with post-secondary education were 60% less likely to report an increase in the number of male sexual partners per week (AOR: 0.4, 95% CI: 0.2 to 0.9), while those who were HIV positive were at twofold the odds of reporting an increase or sustained levels of violence from intimate partners (AOR: 2.0, 95% CI: 1.1 to 4.0).</p><p><strong>Conclusion: </strong>The results of this study demonstrate heterogeneity in participants' access to preventative HIV and clinical care services in Kenya after the onset of the COVID-19 epidemic. These results indicate the importance of responding to specific needs of MSM and adapting programmes during times of crisis.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141535111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-27DOI: 10.1136/sextrans-2024-056160
Olivia T Van Gerwen, Kristal J Aaron, Julia Schroeder, Patricia J Kissinger, Christina A Muzny
Objectives: We aimed to investigate the early natural history of Trichomonas vaginalis in men recently testing positive for this infection by a nucleic acid amplification test (NAAT). We hypothesised that 50% of men would spontaneously resolve their infection (in the absence of treatment) on repeat T. vaginalis NAAT.
Methods: Men ages ≥18 years at the Jefferson County Health Department Sexual Health Clinic testing positive for T. vaginalis by NAAT during standard-of-care (SOC) within the past 30 days and presenting to the clinic for treatment were approached. At enrolment, participants completed a questionnaire, provided urine for repeat T. vaginalis NAAT, and were treated with 2 g oral metronidazole. Those with a repeat positive enrolment NAAT were seen for a 4-week test-of-cure (TOC) visit. At TOC, men provided urine for repeat NAAT. We determined the proportion of men with spontaneous resolution of T. vaginalis and evaluated predictors of spontaneous resolution. In those with a repeat positive enrolment T. vaginalis NAAT, we evaluated the proportion with persistent infection at TOC as a secondary outcome.
Results: Between October 2021 and January 2023, 53 men with a recent positive SOC T. vaginalis NAAT were approached; 37 (69.8%) participated. The mean participant age was 32.9 years (SD 9.9); all identified as Black. The majority (97.3%) reported sex with women only; 35.1% reported sex with >1 partner in the last month. At enrolment, 26/37 (70.3%) had a repeat positive T. vaginalis NAAT in the absence of treatment after an average of 8.4 days (SD 5.9). Sexual partner gender, number of recent sexual partners, genital symptoms, unprotected sex with any partner and recent antibiotic use were not associated with spontaneous resolution. Of the 26 men attending a TOC visit, 17 (65.4%) returned and all except one (94.1%) were cured.
Conclusion: Most men do not spontaneously clear T. vaginalis infection during early repeat testing.
{"title":"Spontaneous resolution of <i>Trichomonas vaginalis</i> infection in men.","authors":"Olivia T Van Gerwen, Kristal J Aaron, Julia Schroeder, Patricia J Kissinger, Christina A Muzny","doi":"10.1136/sextrans-2024-056160","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056160","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to investigate the early natural history of <i>Trichomonas vaginalis</i> in men recently testing positive for this infection by a nucleic acid amplification test (NAAT). We hypothesised that 50% of men would spontaneously resolve their infection (in the absence of treatment) on repeat <i>T. vaginalis</i> NAAT.</p><p><strong>Methods: </strong>Men ages ≥18 years at the Jefferson County Health Department Sexual Health Clinic testing positive for <i>T. vaginalis</i> by NAAT during standard-of-care (SOC) within the past 30 days and presenting to the clinic for treatment were approached. At enrolment, participants completed a questionnaire, provided urine for repeat <i>T. vaginalis</i> NAAT, and were treated with 2 g oral metronidazole. Those with a repeat positive enrolment NAAT were seen for a 4-week test-of-cure (TOC) visit. At TOC, men provided urine for repeat NAAT. We determined the proportion of men with spontaneous resolution of <i>T. vaginalis</i> and evaluated predictors of spontaneous resolution. In those with a repeat positive enrolment <i>T. vaginalis</i> NAAT, we evaluated the proportion with persistent infection at TOC as a secondary outcome.</p><p><strong>Results: </strong>Between October 2021 and January 2023, 53 men with a recent positive SOC <i>T. vaginalis</i> NAAT were approached; 37 (69.8%) participated. The mean participant age was 32.9 years (SD 9.9); all identified as Black. The majority (97.3%) reported sex with women only; 35.1% reported sex with >1 partner in the last month. At enrolment, 26/37 (70.3%) had a repeat positive <i>T. vaginalis</i> NAAT in the absence of treatment after an average of 8.4 days (SD 5.9). Sexual partner gender, number of recent sexual partners, genital symptoms, unprotected sex with any partner and recent antibiotic use were not associated with spontaneous resolution. Of the 26 men attending a TOC visit, 17 (65.4%) returned and all except one (94.1%) were cured.</p><p><strong>Conclusion: </strong>Most men do not spontaneously clear <i>T. vaginalis</i> infection during early repeat testing.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141470545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1136/sextrans-2024-056217
Matthew Chung Yi Koh, Jinghao Nicholas Ngiam, Paul Anantharajah Tambyah, Sophia Archuleta
Objectives: Specific to sexual health, individuals in need of information may be adolescents who have limited ability to formally access healthcare. These digital natives may turn to ChatGPT to address their concerns on sexually transmitted infections (STI). We sought to evaluate the veracity of ChatGPT's responses to commonly asked questions on STIs.
Methods: We instructed ChatGPT (GPT 3.5) to answer STI questions from three domains, namely, (1) general risk factors for STIs, (2) access to care and diagnosis of STIs and (3) management of STIs and postexposure prophylaxis. The responses were recorded and checked against the US Centers for Disease Control and Prevention STI Treatment Guidelines 2021.
Results: Overall, the responses were concise and accurate. In terms of prevention, ChatGPT could also recommend measures like safe sex practices and human papillomavirus vaccination. However, it failed to recommend HIV pre-exposure prophylaxis. When an individual expressed a symptom that could potentially represent STI (eg, dyspareunia) ChatGPT appropriately provided reassurance that other possibilities exist, but advocated for testing. In terms of treatment, ChatGPT consistently communicated the importance of partner testing and follow-up testing, but at times, failed to highlight the importance of testing for other STIs. Overall, the advice given was not tailored to the specific individual's circumstances.
Conclusions: ChatGPT can provide helpful information regarding STIs, but the advice lacks specificity and requires a human physician to fine-tune. Its ubiquity may make it a useful adjunct to sexual health clinics, to improve knowledge and access to care.
{"title":"ChatGPT as a tool to improve access to knowledge on sexually transmitted infections.","authors":"Matthew Chung Yi Koh, Jinghao Nicholas Ngiam, Paul Anantharajah Tambyah, Sophia Archuleta","doi":"10.1136/sextrans-2024-056217","DOIUrl":"https://doi.org/10.1136/sextrans-2024-056217","url":null,"abstract":"<p><strong>Objectives: </strong>Specific to sexual health, individuals in need of information may be adolescents who have limited ability to formally access healthcare. These digital natives may turn to ChatGPT to address their concerns on sexually transmitted infections (STI). We sought to evaluate the veracity of ChatGPT's responses to commonly asked questions on STIs.</p><p><strong>Methods: </strong>We instructed ChatGPT (GPT 3.5) to answer STI questions from three domains, namely, (1) general risk factors for STIs, (2) access to care and diagnosis of STIs and (3) management of STIs and postexposure prophylaxis. The responses were recorded and checked against the US Centers for Disease Control and Prevention STI Treatment Guidelines 2021.</p><p><strong>Results: </strong>Overall, the responses were concise and accurate. In terms of prevention, ChatGPT could also recommend measures like safe sex practices and human papillomavirus vaccination. However, it failed to recommend HIV pre-exposure prophylaxis. When an individual expressed a symptom that could potentially represent STI (eg, dyspareunia) ChatGPT appropriately provided reassurance that other possibilities exist, but advocated for testing. In terms of treatment, ChatGPT consistently communicated the importance of partner testing and follow-up testing, but at times, failed to highlight the importance of testing for other STIs. Overall, the advice given was not tailored to the specific individual's circumstances.</p><p><strong>Conclusions: </strong>ChatGPT can provide helpful information regarding STIs, but the advice lacks specificity and requires a human physician to fine-tune. Its ubiquity may make it a useful adjunct to sexual health clinics, to improve knowledge and access to care.</p>","PeriodicalId":21624,"journal":{"name":"Sexually Transmitted Infections","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}